IOTN , orthodontic treatment need

Background: The malocclusion indices have been used routinely by researchers to gather data regarding the prevalence of orthodontic treatment needs and trait. The scoring methods of malocclusal indices can be used to generate data regarding the actual load of the malocclusion which can be used for resource and fund allocation and identify the actual orthodontic treatment needs. This article will provide an insight to the various orthodontic indices and its specific indications.

DAI HLD ICON IOTN Malocclusion Orthodontic treatment need indices Supporting evidence a b s t r a c t Background and objectives: To date, there is no evidence-based method of quantification for malocclusion. Consequently, how deviant occlusal traits should be scored and weighted relative to one another is a matter of serious debate. Orthodontic Treatment Need Indices (OTNI)

OBJECTIVES:

A cross-sectional study was conducted to determine the level of agreement between the Dental Aesthetic Index (DAI) and the Aesthetic Component (AC) of the Index of Orthodontic Treatment Need (IOTN).
METHODS:

DAI and AC scores were recorded in 728 subjects (340 females and 388 males, aged 11-20 years). The percentage of subjects needing treatment and the different treatment categories for the DAI and AC were gender compared. Spearman's rank correlation coefficient (rho) was used to explore the relationship between the DAI and AC scores. Observer determined and Kappa statistics were used to analyse the diagnostic level of agreement between the DAI and AC, sorted into 'yes' or 'no' categories of orthodontic treatment need.
RESULTS:

According to the DAI and AC, 21.8 and 10.9% of subjects were in need of treatment, respectively. Significant positive correlations existed between the DAI and AC scores (rho = 0.795). The DAI had a lower treatment need threshold compared with the AC. The Kappa statistics and percentage agreement between the DAI and AC was 0.55 (95% CI: 0.46-0.63) and 87.6%, respectively.
CONCLUSION:

The DAI and AC showed strong association. However, only a moderate level of diagnostic agreement was identified (12.4% difference in observed percentage agreement) which highlights the need for a unified and universal orthodontic index for consideration when interpreting, comparing, or quantifying treatment needs.

INTRODUCTION:

This was a cross-sectional study to investigate the agreement between assessments of orthodontic treatment need of the index of complexity, outcome, and need (ICON) and the index of orthodontic treatment need (IOTN).
METHODS:

Five hundred two subjects (253 girls, 249 boys; ages, 11-14 years) participated in this study, including a few who were wearing an orthodontic appliance (1 girl, 5 boys). ICON scores and the aesthetic (AC) and dental health components (DHC) of the IOTN were recorded in those not undergoing treatment. The percentages of subjects needing treatment (ICON score >43) and the different complexity components of ICON were compared between the sexes. Observed percentages of agreement and kappa statistics were used to analyze the agreement between the AC and DHC of the IOTN and also the ICON, and the DHC and AC of the IOTN dichotomized into a yes or no categories of orthodontic treatment need.
RESULTS:

No sex differences were found between male and female subjects for treatment need (ICON score >43; P >0.05) and treatment complexity (P >0.05). The kappa statistic for diagnostic agreement between the DHC and AC of the IOTN was 0.55 (95% CI, 0.48-0.63). The kappa statistics for diagnostic agreement between the ICON and the AC and the DHC of the IOTN were 0.40 (95% CI, 0.33-0.46) and 0.78 (95% CI, 0.73-0.83), respectively. The observed agreement between the DHC and the AC of the IOTN was 81.8%. The observed agreement between the ICON and AC and DHC of the IOTN were 71.3% and 89.5%, respectively.
CONCLUSIONS:

In terms of orthodontic treatment need, there was moderate agreement between the ICON and the AC (IOTN), and between the DHC and the AC. There was good agreement between the ICON and the DHC of the IOTN. The ICON is a good substitute for the DHC of the IOTN.

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Aim: This retrospective cohort study assessed the differences between the masticatory performance of individuals with and without orthodontic treatment need. Methods: Masticatory performances of 120 participants with equal numbers of males and females (n = 60 each) with and without treatment need (n = 60 each, determined using the index of the complexity, outcome, and need [ICON]) matched by age and sex were assessed. Participants chewed on test foods at sequences of 20, 30, 40, 40, 30, and 20 masticatory cycles. After sieving the chewed particles, the masticatory parameters (median particle size [MPS], masticatory frequency [MF], and broadness of particle distribution [BPD]) were calculated. The associations between treatment need and the MPS with age, weight, and stature, as well as the relationship between sex and MPS and MF, were assessed. Results: According to the independent samples t test, MPS of subjects with and without treatment need differed significantly (P < .05) while MF did not. The differences between BPD values reached the level of significance only after 40 cycles of mastication (P < .05). Females showed significantly greater MPS values. Only at the 40-cycle sequence did females in need of treatment chew significantly slower. According to the repeated-measures ANOVA, no significant differences existed (P > .05) between each of the MPS, MF, and BPD values measured at different sequences. No significant correlations were found between MPS and age, sex, or stature (P > .05 [Spearman correlation coefficient]). Conclusion: The masticatory performance of individuals with and without treatment need differed for MPS and BPD (at the 40-cycle sequence). Age, weight, and stature did not affect the treatment need and MPS. Females showed poorer results regarding MPS-only at the 40-cycle sequence did females with malocclusion chew significantly slower.

Occlusal indices have been introduced and used to rank or categorize the occlusion. According to Dr. William Shaw and colleagues (1995), there are five types of occlusal indices,
diagnostic, epidemiologic, orthodontic treatment need, orthodontic treatment outcome, and treatment complexity indices. Orthodontic treatment need indices are used to rank
the malocclusion. They were devised to minimize the subjectivity associated with the diagnosis, referral and complexity assessment of malocclusion. Some are also multifunctional and used to assess the outcome of orthodontic treatment. The overall aim of the present article is to provide an overview on four commonly used American and European orthodontic treatment need indices, review their modifications, advantages, and limitations. These indices are the Index of Orthodontic Treatment Need (IOTN), the Dental Aesthetic Index (DAI), the Handicapping Labio-Lingual Deviation index (HLD), and the Index of Complexity,
Outcome and Need (ICON).